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2013г. №1 Print E-mail

CONTENTS

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HEALTH AND SOCIETY

Zalyalova Z.A., Zalyalova D.F. Russia and WTO: non-discrimination principle in the medical services .....................................7

Efros L.A., Kalev O.F. Regional features of disability of patients with ischemic heart disease after coronary bypass surgery between 2000 and 2009............................10

Markova T.N., Gerasimova L.I., Kichigin V.A., Kochemirova T.N. Gender features of behavioral risk factors for non-communicable diseases in the evaluation of obesity.........16

 

Medvedskaya D.R. Evaluation of effectiveness of measures aiming at decreasing vascular diseases mortality rate of population of Sverdlovsk oblast ..........20


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PROTECTION OF MATERNITY AND CHILDHOOD

Fedorova G.V., Klimshina T.K., Vyaltsin S.V. Prevention of incidence of young men of military and preinduction age of Khanty-Mansiysk..............................................................26

Agaev F.B., Nagdaliev A.S., Alieva K.J. Criterial significance of perinatal losses in evaluating the effectiveness of medical care........................................................................29

 

Chechulina O.V., Orlova Y.A. Role of displasia of the connective tissue in formation of reproductive health of girls-teenagers......................................................................32


HEALTH OF ECONOMICALLY ACTIVE POPULATION

Hlapov A.L., Kamaev I.A., Pozdeeva T.V., Ivanov M.A. The analysis of the structure and qualification of medical personnel in Russia and abroad.......................................................37

 

Mikhailov M.K., Laryukova E.K. Improvement possibilities of postgraduate training system for radiologists in modern conditions (discussion)...........................40


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ORGANIZATION AND IMPROVEMENT OF PROTECTION SYSTEM MANAGEMENT OF PUBLIC HEALTH

Zangerova E.Y., Molchanova L.F., Zlobina G.M. The principle of integration of blood services of health care institutions of Mari El.........................................................................45

Beylina N.I., Gazizov R.M., Nizamov I.G. The hospital’s application of replacing technologies in treatment of the students, suffering by erosion-ulcer defects and digestion.........49

 

Gerasimova L.I., Matveev R.S., Viktorov V.N. The analysis of out-patients’ service efficiency..52


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QUALITY OF MEDICO-SOCIAL SECURITY OF THE POPULATION

Khasanov R.Sh., Shakirov K.T., Rabbaniev I.F., Gabitova S.E. Scientific and practical approaches to formation of a control system by quality of medical aid at malignant neoplasms in the Republic of Tatarstan.......................................56

Rodin N.V., Kudrina E.A., Kamalova E.I., Orlova O.V. Monitoring of quality of medical care in system of non-state establishment of health care of JSC «Russian Railways»...................60

Kudrina E.A., Smolin A.A. Quality of life of patients with the cerebral stroke, being at a stage of rehabilitation treatment ....................................................................63

Ermakova M.K., Kapustina N.R., Ermakov G.I., Yasavieva R.I., Strelkova T.N., Russkikh L.V., Omelyanyuk I.V., Ryabova L.V., Berestova Y.V. Life quality as the index of disease adaptation degree as exemplified in cases of bronchial asthma among children and chronic pulmonary disease among adults..............................................................65

 

Khairullina S.G., Saifutdinov R.G. Quality of life among patients with chronic heart failure and factors affecting on it............72


Russia and WTO: non-discrimination principle in the medical services 

Z.A. Zalyalova, D.F. Zalyalova

Abstract. Russia’s statutory instruments have been studied, including the World Trade Organization (WTO) legislation, which has been integrated into Russia’s legal framework for health services; potential consequences of Russia’s inclusion into WTO have been described. The methodical ground of the study consists of scientific and specific juridical methods of cognition: logical analysis, synthesis, historic-legal, formal-legal, and comparative-legal. The conclusion has been made that by compliance with the WTO rules and the Russia’s commitments, WTO entry will not affect the medical services sphere significantly. 

 

Key words: WTO, non-discrimination principle, health care, medical services providers, obligatory medical insurance (OMI).


Regional features of disability of patients with ischemic heartdisease aftercoronary bypass surgery between 2000 and 2009

L.A. Efros, O.F. Kalev

Abstract. The aim of the study was to investigate the measurement of disability of patients with ischemic heart disease after coronary bypass surgery. The results show the characteristics of health and demographic indicators of 2 398 patients, including 2 169 (90.5%) men and 229 (9.5%) women who had surgery at the Chelyabinsk interregional cardiac centers from 2000 to 2009. The average age at surgery was 54.8±6.3 years. Despite advances and the increasing number of coronary bypass surgery by factor of 10 times, in the late period (from 1 to 10 years) after the operation, the number of people with disabilities was 60.5%, including 72.4% of disabled people of working age.

 

Key words: coronary artery bypass surgery, a disability.


Genderfeatures of behavioral risk factors fornon-communicable diseases INthe evaluation of obesity

T.N. Markova, L.I. Gerasimova, V.A. Kichigin, T.N. Kochemirova

Abstract. Investigation was made in the theme of the distribution of free sample of residents in the Chuvash Republic of risk factors for noncommunicable diseases (eating disorders, low physical activity (PA), alcohol abuse, smoking) and their association with obesity (OJ). The study included 2608 men, 1531 women and 1077 men revealed a high prevalence of behavioral risk factors for non-communicable diseases in the population. The frequency of smoking was 48,5% in men and 3,4% of women, abuse of alcohol — 18,2% and 2,3%, respectively, eating disorders — 47,0% and 78,6%, low physical activity — 83,8% and 90,3%. In women, a statistically significant risk factors are low coolant PA and eating disorders, in male eating disorders.

 

Key words: obesity, physical activity, smoking, alcohol, eating behavior.


Evaluation of effectiveness of measures aiming atdecreasing vasculardiseases mortality rate of population of Sverdlovsk oblast

D.R. Medvedskaya

Abstract. The article reflects the results of evaluating the effectiveness of realization of federal program measures on improving the quality of medical services provided to patients with vascular diseases in Sverdlovsk Oblast. Due to establishing the net of intermunicipal vascular centers at part of its territory, cerebrovascular mortality rate has become 2.9 times lower, but at the same time the tendency of cardiovascular mortality rate increase has not been changed. It is concluded that: 1) it’s advisable to widen the net of vascular centers in the region; 2) it’s necessary to improve the program measures with regard to cardiovascular diseases.

 

Key words: vascular diseases, objective program, effectiveness.


Prevention of incidence of young men of military and preinduction age of Khanty-Mansiysk

G.V. Fedorova, T.K. Klimshina, S.V. Vyaltsin

Abstract. Some results of performance of scientific research are given in the article. The accent is made on results of carrying out sociological poll of doctors-pediatricians, parents and teenagers. Research is added with the information about the level of health of teenagers from stories of development of the child. Treatment of the findings is carried out with use of such methods of statistics, as the alternative analysis, the reliability assessment, the graphic analysis, criterion of compliance, the factorial analysis.

 

Key words: incidence, prevention, young men of military and preinduction age.


Criterial significance of perinatal losses in evaluating the еffectiveness of medical care

F.B. Agaev, A.S. Nagdaliev, K.J. Alieva

Abstract. The dependence of perinatal losses from maternal age and body weight of the fetus and newborn at birth was studied in the researches based on the materials of the perinatal center of Azerbaijan Republic. Two options of the distribution of fetuses and newborns according to weight intervals (500 and 2500g) were tried out. It is established that the composition of fetuses and newborns according to body weight at birth among mothers of different ages differs from each other. When using indicators of perinatal losses for evaluating the functioning effectiveness of perinatal services, options of classification of fetuses and newborns according to body weight at birth and age of their mothers need to be considered.

 

Key words: perinatal mortality, weight of the fetus and newborn, maternal age.


Role of displasia of the connective tissue in formation of reproductive health of girls-teenagers

O.V. Chechulina, Y.A. Orlova

Abstract. Preservation and strengthening of health of teenagers — the most important problem of today as only healthy parents can have healthy children. Today there is a set of problems in reproductive health of the girls interfaced from dysplasia of the connective tissue. The clinical importance of the syndrome of dysplasia of the connective tissue is defined by that a dysplasia of the connective tissue is essentially reflected in character and a course of acquired diseases. 

 

Key words: somatic and reproductive health of children and teenagers, dysplasia of the connective tissue.


The analysis of the structure and qualification of medical personnel in Russia and abroad

A.L. Hlapov, I.A. Kamaev, T.V. Pozdeeva, M.A. Ivanov

Abstract. The quantity, structure and qualification of medical personnel in Russia in comparison with the countries of the Organization for Economic Co-operation and Development (OECD) are analysed in the article. The main causes of the appeared problems in providing medical personnel and their qualification are considered in the article. The international experience of improvement of qualification of medical personnel has been adduced. The main tasks and mechanisms of providing of the Russian system of health care by skilled medical personnel are also enumerated.

 

Key words: medical personnel, structure and qualification of medical personnel quality of medical aid, medical education.


Improvementpossibilities of postgraduate training system forradiologists in modern conditions (discussion)

M.K. Mikhailov, E.K. Laryukova

Abstract. Wide spread of modern diagnostic equipment and new radiology methods shows us the need of new approaches for radiologists studying. According to foreign and our own large pedagogical experience, we tried to develop new conception of primary study and professional development for radiologists.

 

Key words: postgraduate training, radiologists


The principle of integration of blood services of health care institutions of Mari El

E.Y. Zangerova, L.F. Molchanova, G.M. Zlobina

Abstract. The analysis of media consumption blood transfusion health care system of the Republic of Mari El has been made, the factors affecting the formation of needs have been determined. These factors include the volume and complexity of the treatment, the number of hospital beds in the surgical hospitals that provide emergency care, the dynamics of malignant tumors. In the calculation of the planned volume of procurement of donor blood components it is expedient to rely on the analysis of previous periods with the issuance of the components on a single fixed bed.

 

Key words: service of blood, volumes of procurement of donor blood, blood components, healthcare institutions.


The hospital’s application of replacing technologies in treatmentof the students, suffering by erosion-ulcerdefects and digestion

N.I. Beylina, R.M. Gazizov, I.G. Nizamov

Abstract. Expenditure of conducting patients with erosion-ulcer defects of bodies of gastroenteric path in conditions of a hospital, and also the break in study for the period of treatment makes by an actual problem wide use a hospital of the replacing technologies giving an opportunity to combine treatment and study. The purpose of research is studying of features epidemiologic and clinics of erosion-ulcer defects of gastric-duodenal zones at group of dynamically observable students with the subsequent substantiation of an opportunity cure sick students in conditions of an ambulance station and introduction in daily practice a hospital of replacing technologies. Selection patients (359 person) for out-patient treatment and treatment in a day time hospital were carried out at favorable current of disease, absence of needs in round-the-clock treatment and supervision. After results it has been established, that stomach ulcer at training youth from group of observation has favorable current (the small experience, easy current with infrequent aggravations at moderately expressed semiology, rare complications, mainly optimum weight of a body), and it is possible to treat sick students in conditions of an ambulance station. From 359 consulted patients 241 out-patient persons were conducted. 113 persons have been directed on the treatment in a day time hospital. Therapy passed without educational employment. Students received treatment according to reports of conducting gastroenterology patients. Repeated references behind medical aid among the patients treated by us have not been registered during one year.

 

Key words: erosion-ulcer defects of gastric-duodenal zones, a hospital replacing technologies.


The Analysis of out-patients’ service efficiency

L.I. Gerasimova, R.S. Matveev, V.N. Viktorov

Abstract. One of the essential problems is ineffective management of healthcare system. Out-patients’ service is primary part of public healthcare system. Here are the results of experts’ estimation of the regional out-patients’ service activity in the article.

 

Key words: efficiency, out-patients’ service, morbidity, mortality.


Scientific and practical approaches to formation of a control system by quality of medical aid atmalignantneoplasms in the Republic of Tatarstan

R.Sh. Khasanov, K.T. Shakirov, I.F. Rabbaniev, S.e. Gabitova

Abstract. In the given work the system of measures for improving the management of primary medical aid at malignant diseases on the territory of the Republic of Tatarstan is presented. The efficacy of patients’ routing to the oncological institution with the aim of defining the tactics of cancer patients conducting, health supervising, monitoring the health state of patients in the groups of risk is shown (during the period from 2009 to 2011 a share of patients revealed at early stages of a disease increased by 8%, the indicator of an one-year lethality decreased by 1,8% in the Republic of Tatarstan).

 

Key words: malignant neoplasm, routing of patients, organization of medical aid to cancer patients.


Monitoring of quality of medical care in system of non-state establishmentof health care of JSC«Russian Railways»

N.V. Rodin, E.A. Kudrina, E.I. Kamalova, O.V. Orlova

Abstract. Results of interdepartmental monitoring of quality of medical care (QMC) in non-state establishment of health care are presented. It is shown that the developed and introduced complex assessment of QMC allows to reveal problem zones in technological process of rendering of medical care; to develop offers on elimination of the reasons of their emergence and to form individual algorithm of an assessment of QMC in the specific medical organization. 

 

Key words: quality of medical care, non-state establishment of health care, treatment level of quality, interdepartmental examination of quality of medical care.


Quality of life of patients with the cerebral stroke, being ata stage of rehabilitation treatment

E.A. Kudrina, A.A. Smolin

Abstract. The assessment of quality of life of 138 patients with the cerebral stroke being at the stage of stationary rehabilitation treatment in the conditions of regional vascular center is carried out. Research was carried out by means of Medical Outcomes Study 36-Item Short Form Health Survey questionnaire. It is established that patients initially had statistically authentically low level of quality of life in comparison with population norm, especially on scales «the general perception of health» and «psychological health» which indicators were less for 73,6% and 62,3% respectively. Carrying out rehabilitation actions allowed improving authentically quality of life’s statistics indicators, especially on the block «a physical component of health» that has important medico-social value. 

 

Key words: patients with a cerebral stroke, rehabilitation, the regional vascular center, MOS SF-36, quality of life.


Life quality as the index of disease adaptation degree as exemplified in cases of bronchial asthma among children and chronic pulmonary disease among adults

M.K. Ermakova, N.R. Kapustina, G.I. Ermakov, R.I. Yasavieva, T.N. Strelkova, L.V. Russkiкh, I.V. Omelyanyuk, L.V. Ryabova, Y.V. Berestova

Abstract. The life quality of children with bronchial asthma and life quality of adults with chronic obstructive pulmonary disease were studied during the research. The life quality decrease was stated depending on the illness severity both in children and adults. However, more significant changes were depicted in the life quality of adults with chronic obstructive pulmonary disease.

 

Key words: life quality, bronchial asthma, chronic obstructive pulmonary disease.


Quality of life among patients with chronic heartfailure and factors affecting on it

S.G. Khairullina, R.G. Saifutdinov

Abstract. Chronic heart failure (CHF) it is one of the major complications of the cardiovascular diseases. Quality of life is getting worse with the growth stage and worsening of its degree. The most common causes of CHF are ischemic heart disease and myocardial infarction, dilated cardiomyopathy, and rheumatic heart disease, arterial hypertension and type 2 diabetes. It is important to identify potentially reversible factors influencing the development and progression of heart failure, thus worsening the quality of life. The identification, elimination and prevention of these factors are the most important tasks of the clinician that, ultimately, improve the quality of life among patients with CHF. Heart failure often occurs with arrhythmia that requires correction by antiarrhythmics. The most effective drug is amiodarone. It bloks K+ — channels, and therefore its effect is more pronounced during the development of antiarrhythmias. Improving the work of the K+ — channels can increase opportunities adaptation of the heart, reduce the degree of heart failure, and improve the quality of patients’ life.

 

Key words: chronic heart failure, ischemic preconditioning, antiarrhythmic drugs.